Gabriela Maria Antezana

Individual provider Active NPI Behavior Technician · Lafayette, CA

NPI 1902407331 · NPPES record last updated Nov 3, 2020

Key facts

NPI
1902407331
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3650 Mt Diablo Blvd Ste 107L
Lafayette, CA 94549-3780
Phone
(510) 665-9700
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3650 Mt Diablo Blvd Ste 107L
Lafayette, CA 94549-3780

Mailing address

PO Box 399318
San Francisco, CA 94139-9318

Other practice location 1

8 Tofflemire Dr
Lafayette, CA 94549-4947
Phone (925) 876-5973

Other providers in Lafayette, CA

All providers in Lafayette, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.